Page:Clinical Lectures on the Diseases of Women.djvu/39

Rh liar to women; but I am not sure of this. I think it has rivals in chronic ovaritis, and in chronic inflammation of the uterus and ovaries. Yet there is no doubt its commonness justly gives it great interest and prominence.

I cannot pass on without saying a few words on the historical position of this disease, "ulceration of the womb." This history is an illustration, and in some respects not a creditable illustration, of the medical philosophy of this century. It shows that the period of medical enthusiasms, not yet passed, has characters, besides those of weakness, allying it with passing religious enthusiasms. Ulceration was raised into the position of a gynæcological system, and all the diseases of women were managed accordingly. I can well remember—indeed all except students cannot fail to do so—how, over the whole world, gynæcological practitioners were busy with speculum and caustic, and thought they had in these tools a panacea for the diseases of women.

Luckily for you, great medical systems are unknown now. Had you been students a generation or two ago, you would have been taught, as your paramount acquirement, a system—of Boerhaave, or of Cullen, or of Broussais; and you would have been carefully indoctrinated, it being held that you could not practise safely without the guidance of a system, and that in all your dealings with your patients you should keep the system before you as your guiding star. Just so was it with the little ulceration system in gynæcology. We must stamp out these premature systems in medicine, and in gynæcology too.

The re-introduction of the speculum in the early part of this century, by Récamier, showed, as a striking and frequent phenomenon in women, a redness around the os uteri, which was called an ulcer. This discovery is the real commencement of modern gynæcology. It ripened into the